Yoga Intervention May Reduce Mood Disturbance, Anxiety, Fatigue, and Insomnia in Cancer Survivors
A 4-week yoga program called Yoga for Cancer Survivors (YOCAS) reduces mood disturbance, anxiety, and fatigue in cancer survivors, according to a phase III randomized controlled trial presented June 1, 2026, at the ASCO Annual Meeting. The study found these improvements also help decrease insomnia among participants.
The trial, presented as Abstract 12004, involved 410 survivors of nonmetastatic cancer from 12 community-based oncology practices across the United States. Participants were randomly assigned to either standard survivorship care or standard care combined with the YOCAS intervention.
According to study author Yuri Choi, PhD, MSN, RN, of the University of Rochester Medical Center, there is no single gold standard behavioral treatment for treating these four interrelated side effects. The YOCAS trial aims to fill that gap by providing a structured, non-pharmaceutical option.
How does the YOCAS yoga program work?
The YOCAS intervention consists of a 4-week program featuring gentle hatha and restorative yoga postures, mindfulness, and breathing exercises. Participants attended two 75-minute instructor-led sessions per week and performed at least 30 minutes of home-based practice weekly.
To ensure consistency, 35 yoga instructors underwent specialized training. Participants also received a kit containing a yoga mat, strap, manual, and instructional videos to support their home practice.
The study group had a mean age of 54 years. Of the 410 participants, 96% were female, 93% were White, and 75% were breast cancer survivors. Eligible participants had to be 21 years or older and between 2 to 24 months post-primary treatment.
What were the specific results for cancer survivors?
Participants in the YOCAS group showed significant reductions in symptoms compared to those receiving standard care alone. The intervention was associated with a 5.08-point lower total score for overall mood disturbance, which researchers categorized as a moderate-to-large effect.
Anxiety scores were 0.72 points lower, reflecting a small-to-medium effect. Fatigue scores dropped by 1.49 points, a medium-to-large effect. The standard-care group did not show these improvements from baseline to post-intervention.
Fumiko Chino, MD, FASCO, an ASCO Expert in survivorship and Associate Professor at MD Anderson Cancer Center, said the data supports yoga as a nonpharmacologic option. She noted that survivors often manage multiple medications, making a non-pharmaceutical solution for four different side effects an important advance.
Why does yoga improve sleep for survivors?
The study used mediation analyses to determine how YOCAS affected insomnia. Researchers found that improvements in fatigue and overall mood disturbance each accounted for approximately 25% of the improvements in insomnia.
This suggests that the yoga intervention improves sleep both directly and indirectly. By reducing other common survivorship symptoms, the program helps resolve sleep disruptions.
Julie R. Gralow, MD, FACP, FASCO, Chief Medical Officer of ASCO, stated that the study confirms yoga as a scientifically proven tool to combat cancer-related fatigue. She added that gentle, evidence-based practices are safe and effective for managing symptoms during and after treatment.
What happens next for YOCAS research?
Investigators concluded that clinicians should consider recommending gentle hatha and restorative yoga for survivors experiencing insomnia, anxiety, fatigue, or mood disturbance.
Future research may examine the long-term effects of the YOCAS program. The study team also plans to explore digital delivery methods, such as mobile apps and online platforms, to expand patient access.
Additional research is likely to focus on high-risk groups, including rural populations and adolescent and young adult survivors.
Frequently Asked Questions
Who was eligible to participate in the YOCAS trial?
Eligible participants were survivors of nonmetastatic cancer, aged 21 or older, who were 2 to 24 months post-primary treatment, experienced moderate or greater sleep disruption, and had not practiced yoga in the previous three months.
What specific types of yoga were used in the program?
The program used gentle hatha and restorative yoga postures combined with mindfulness and breathing exercises.
What tools were provided to the participants for home use?
Participants received a YOCAS kit that included a yoga mat, a strap, a manual, and instructional videos.
Would you consider a structured yoga program as part of a cancer recovery plan?